Macular Degeneration Treatments and Research
Scientists are tirelessly researching treatments for age-related macular degeneration (AMD). This condition is called age-related macular degeneration because it’s more common in people 60 and older.
There are several promising approaches. To understand them better, one first needs to distinguish between two types of macular degeneration: dry and wet. Each type calls for a different treatment plan.
Currently, the available treatment options have limitations, and unfortunately do not provide a cure. What they may accomplish is a slowing-down of the disease’s progression.
To learn more, contact Dr. Peter DeGraziano, OD, FIALVS, who helps low vision patients live independent, fulfilling lives. Thanks to vision aids, devices, and training problem-solving skills, patients can do more of the things that they enjoy, such as drive, read, cook, or recognize the faces of loved ones.
Dry Macular Degeneration Treatment
The majority of patients have dry macular degeneration, which is caused by deposits of yellow matter, called drusen, that form underneath the macula. Drusen are like tiny collections of debris or retinal waste products that are not removed effectively and therefore can build up over time. Having a few hard drusen is normal as you age. Most adults have at least one hard drusen.
There are two different types of drusen:
- “soft” drusen are large and cluster closer together
- “hard” drusen are smaller and more spread out
This type of drusen typically does not cause any problems and doesn’t require treatment.
Soft drusen, on the other hand, is associated with age-related macular degeneration (AMD).
As soft drusen becomes larger, they can cause bleeding and scarring in the cells of the macula, and in time, AMD can result in permanent central vision loss.
Currently, there is no approved medical treatment available, and patients are advised to follow specific nutritional protocols, including supplements. Low vision glasses and devices, such as hand, stand, and electronic magnifiers are recommended to maximize vision.
Wearing sunglasses to protect the eyes from potentially dangerous light can help prevent AMD and possibly slow down its progression. Smoking is also known as a significant risk factor.
Recommended Nutrition for Dry AMD
In general, nutrition therapy is the mainstay of treatment for dry macular degeneration. To strengthen the cells of your macula, it’s essential to eat healthy foods rich in antioxidants. Green leafy vegetables, particularly spinach and kale, and carotenoid-containing foods, are recommended if you experience signs of AMD or have a family history of AMD. Furthermore, be sure to eat plenty of fish and foodstuffs rich in omega-3.
Why should a person consider taking macular degeneration vitamins? Isn’t a good diet enough?
It is nearly impossible to get all of the nutrients needed for the prevention and treatment of AMD in a standard North American diet. For example, the average American consumes only 1-2 mg of lutein per day — considerably less than the 10-15 mg daily recommended dose for patients with AMD.
While we recommend that patients follow a diet low in carbohydrates, and abundant in fresh, leafy green vegetables, along with lean protein, such as fatty fish (salmon, tuna, mackerel), a good diet on its own is not enough to fight AMD.
What should a person look for when selecting macular degeneration vitamins?
Vitamins and Supplements
Look for eye vitamins that have incorporated the latest science and research.
We now know that vitamin D, B-Complex vitamins, and amino acids are all critical in not
only slowing AMD but in preventing the conversion from dry to wet macular
degeneration. There’s also mounting evidence that Omega-3 fatty acids in the triglyceride-lowering (TG) form may enhance the efficacy of anti-VEGF injections.
Dr. Peter DeGraziano, OD, FIALVS can recommend specific vitamins.
Wet Macular Degeneration Treatment
Wet macular degeneration is caused by new, fragile blood vessels that form underneath the macula, and then leak blood or fluid, causing the macula to lift. The current standard of treatment is intravitreal injections. These have many limitations and need to be repeated frequently.
Wet AMD can cause sudden and permanent vision loss, so if vision becomes blurry it is essential to contact Dr. Peter DeGraziano, OD, FIALVS immediately.
Anti-VEGF Injection Therapy
Injection treatments with anti-VEGF drugs are the current standard of care. VEGF is a molecule that encourages the growth of blood vessels. In AMD patients, new abnormal blood vessels form underneath the macula and leak blood and fluids. To inhibit the growth of these weak blood vessels, doctors inject an anti-VEGF drug into the eye. Injections need to be repeated in specific intervals.
Researchers see a high success rate in the use of anti-VEGF injections, including a slower progression of the disease, and in some cases, minor benefits to existing vision. Like all medical treatments, anti-VEGF therapy comes with possible risks and side effects. Every individual must discuss the suitability of this treatment with their eye doctor.
Research on Macular Degeneration Treatment
- When it comes to dry macular degeneration, research efforts focus on antioxidant vitamins, such as lipoic acid. Further research is being done with intravitreal injections of different substances. At this time the results are still unclear.
- For wet macular degeneration, much of the research concentrates on the use of anti-VEGF drugs. A device known as PDS (Port Delivery System) could reduce the frequency of visits to a doctor to receive treatment. The device is an implant into the wall of the eye that slowly releases an anti-VEGF drug.
- Research involving a type of eye drops used to treat glaucoma shows a decrease in fluid buildup in the retina when used in conjunction with an anti-VEGF injection.
- Another direction researchers are making progress in is gene therapy. Many believe that, within the foreseeable future, it will be possible to replace faulty genes that cause degeneration of the macula. This is particularly interesting for patients with genetic macular degeneration diseases, such as Stargardt’s and Best.
- The injection of stem cells into the eye that will induce the creation of new cells on the macula instead of the ones that degenerated is an additional possibility scientists are investigating.
Many additional studies are underway, including cell transplantation, immune system strategies, and blood fat control. A variety of implants to protect or restore vision are also being researched.
What You Need To Do
Keep yourself informed about the latest developments. Make sure to see Dr. Peter DeGraziano, OD, FIALVS who will recommend low vision assistive devices to help you with everyday tasks. All of us at Peter E DeGraziano, OD, PC want you to maintain your independence and remain active with macular degeneration.
Peter E DeGraziano, OD, PC serves low vision patients in San Diego, Santee, Encinitas, Oceanside, and throughout California.